Involving patients in improvement work is still unusual but research indicates that co-production can be supported by training professionals. A case study of an adapted training program for professionals at Bräcke diakoni identify aspects of promoting and hindering co-production in quality improvement work. A new measurement instrument has been used to clarify the concept of co-production for participants and for measuring the degree of patient participation in central steps of improvement work. The instrument helped staff to reflect on the degree of patient participation and to encourage involving patients even more. Aspects of promoting factors of co-production were authentic relationships, experience of using improvement tools and exchange of ideas and experiences. In addition, staff expressed reluctance to using patients´ time and energy to improve the service of the organization instead of focusing on their own recovery.